Healthcare Provider Details

I. General information

NPI: 1003308511
Provider Name (Legal Business Name): ELIZABETH BARBER, D.D.S., M.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2018
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 EISENHOWER PARKWAY SUITE 200
ANN ARBOR MI
48108
US

IV. Provider business mailing address

3100 EISENHOWER PARKWAY SUITE 200
ANN ARBOR MI
48108
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-3368
  • Fax: 734-971-3979
Mailing address:
  • Phone: 734-971-3368
  • Fax: 734-971-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number2901020165
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2901019552
License Number StateMI

VIII. Authorized Official

Name: DR. ELIZABETH A BARBER
Title or Position: PRESIDENT
Credential: D.D.S., M.S.
Phone: 734-971-3368